Sleep problems in bipolar disorders: more than just insomnia

<jats:sec><jats:title>Objective</jats:title><jats:p>Sleep problems in bipolar disorder (<jats:styled-content style="fixed-case">BD</jats:styled-content>) are common, but reported rates vary from 10% to 80%, depending on definitions, methodologies and management of potential confounding factors. This multicenter study seeks to address these issues and also compares <jats:styled-content style="fixed-case">BD</jats:styled-content> cases with Hypersomnia as well as the more commonly investigated Insomnia and No Sleep Problem groups.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A cross‐sectional comparison of sleep profiles in 563 <jats:styled-content style="fixed-case">BD</jats:styled-content> I and <jats:styled-content style="fixed-case">II</jats:styled-content> individuals who participated in a structured assessment of demographic, clinical, illness history and treatment variables.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Over 40% cases met criteria for Insomnia and 29% for Hypersomnia. In univariate analysis, Insomnia was associated with <jats:styled-content style="fixed-case">BD II</jats:styled-content> depression whilst Hypersomnia was associated with <jats:styled-content style="fixed-case">BD</jats:styled-content> I depression or euthymia. After controlling for confounders and covariates, it was demonstrated that Hypersomnia cases were significantly more likely to be younger, have <jats:styled-content style="fixed-case">BD</jats:styled-content> I and be prescribed antidepressants whilst Insomnia cases had longer illness durations and were more likely to be prescribed benzodiazepines and hypnotics.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Whilst Insomnia symptoms are common in <jats:styled-content style="fixed-case">BD</jats:styled-content>, Hypersomnia is a significant, frequently underexplored problem. Detailed analyses of large representative clinical samples are critical to extending our knowledge of differences between subgroups defined by sleep profile.</jats:p></jats:sec>